Empagliflozin Effectively Reduces Risk for Heart Failure Hospitalization

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Approximately 50% of deaths in people with type 2 diabetes worldwide, and approximately two-thirds of deaths in people with type 2 diabetes in the US are caused by cardiovascular disease.
Approximately 50% of deaths in people with type 2 diabetes worldwide, and approximately two-thirds of deaths in people with type 2 diabetes in the US are caused by cardiovascular disease.

The following article is part of conference coverage from the 2018 AHA Scientific Sessions in Chicago, Illinois.The Cardiology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in cardiology. Check back for the latest news from AHA 2018.

CHICAGO — Patients with type 2 diabetes (T2D) treated with empagliflozin as part of routine clinical care experienced a decrease in risk of heart failure hospitalization, according to research presented at the American Heart Association Scientific Sessions 2018, held November 10-12, in Chicago, Illinois.

To evaluate the comparative effectiveness, safety, and healthcare utilization of empagliflozin after the landmark EMPA-REG OUTCOME trial (NCT01131676), researchers identified a 1:1 propensity score-matched cohort of 14,414 patients with T2D from 2 commercial datasets and Medicare claims data. These individuals were ≥18 years old and initiating empagliflozin or a dipeptidyl peptidase-4 inhibitor (DPP4i), who did not take a sodium-glucose cotransporter-2 inhibitor (SGLT2i) or DPP4i in the prior year.

Researchers estimated hazard ratios (HRs) and 95% confidence intervals controlling for >120 baseline characteristics in each dataset and pooled by fixed-effects meta-analysis. Further, SGLT2i and DPP4i comparative analyses were also performed.

The outcomes reported included a heart failure discharge diagnosis in the primary position (HHF-Primary), and a heart failure discharge diagnosis in any position (HHF-Any).

Compared with DPP4i, empagliflozin was associated with a 48% decrease in HHF-Primary risk, though this was not statistically significant as it was based on a limited number of events.

Empagliflozin also decreased the risk of HHF-Any by 49% in both patients with and without history of cardiovascular disease.

In a press release that accompanied the study2, Elisabetta Patorno, MD, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, and study co-investigator said “with more hospital admissions for heart failure in the United States every year, it's important to understand whether the relative risk reduction in hospitalization for heart failure seen in the EMPA-REG OUTCOME trial translates into routine clinical care.”

For more coverage of AHA 2018, click here.

Reference

  1. Patorno E, Pawar A, Franklin J, et al. Empagliflozin and the risk of heart failure hospitalization in routine clinical care: a first analysis from the empagliflozin comparative effectiveness and safety (EMPRISE) study. Presented at: American Heart Association Scientific Sessions 2018; November 10-12, 2018; Chicago, IL. Abstract Sa1112 / 1112.
  2. Initial results from EMPRISE real-world evidence study show Jardiance® was associated with reduced risk for hospitalization for heart failure compared with DPP-4 inhibitors in people with type 2 diabetes with and without cardiovascular disease [news release]. Ridgefield, CT. and Indianapolis, IN: Boehringer Ingelheim. [https://www.boehringer-ingelheim.us/press-release/initial-results-emprise-real-world-evidence-study-show-jardiance-was-associated] November 5, 2018. Accessed November 7, 2018.
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